? Tresaderm Steroid - Diabetic cat

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djett

djett

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Hello! My 13lb 15 1/2 year old Birman Gucci previously had DKA last feb and has been regulated since about mid May. He also has kidney disease (creatine avg 3.5, BUN avg 52) and takes the following
  • 1 unit of insulin (Glargine) twice a day
  • low carb low phosphorus kidney diet (Weruva wx, Weruva truluxe, Weruva BFF).
  • 1 scoop of Phos-Bind aluminum hydroxide twice a day since June
  • 100ml sub-q fluids every 3 days since July
  • monthly shot for Solensia (arthritis) since June
  • I get a full blood panel every month w/ urine culture when I take him in for his Solensia, and check Fructosamine every couple of months (always comes out great). This month his kidney values were down from last month(3.2 and 44 BUN, SDMA 18), phosphorus slightly up, Glucose normal, everything else looked good including Thyroid and Urine. Also checked for ketones in urine this morning and cam e back negative
Saturday I noticed that he was constantly scratching his ear, and was shaking and tilting his head alot and walking very wobbly so I took him in. They did an ear swab/exam and ear cleaning and sent me home with ear drops (Tresaderm) to give him twice a day, as well as an ear cleaning solution to use every 2 days.

Guccis BG was 120 last night and he was a little lethargic, however this morning he threw up white foam twice, didnt eat, and his BG was 148 this morning and then 155 3hrs later with no food but given ear drops. He's having alot of trouble walking, is squinting, licking the air constantly, and looks to be in a little bit of pain. I called my vet and unfortunately they said there aren't any other alternatives that don't have a form of steroid in them and that it shouldnt spike too high but monitor his BG and symptoms.

Has anyone had experience with Tresaderm / ear infections with Diabetic cats? Are these symptoms of lethargy, weak, wobbling normal and if so will the medication cause it to only temporarily spike? I was thinking of temporarily stopping the aluminum hydroxide in case theres some kind of toxicity for long term use, although my vet doesnt feel thats the case and says he needs it for his phosphorus. Research online seems to back his theory up since it seems very rare, however interested in your thoughts/experiences.

Thanks!
Devin
 
I haven't used ear drops either. But Tresaderm contains a steroid so will likely raise the BG.
 
Thank you all for the replies, his BG is now down to 88 (alphatrak 3) and he's going on almost 24hrs of not eating so am going to skip tonights insulin unless something changes and monitor his BG with the ear drops. I'm giving him sub Q fluids to keep him somewhat hydrated but if he doesnt eat by tomorrow i'll probably take him in to see if theres something else running concurrent with his ear infection like pancreatitis or similar.

Thanks again
 
I've used Tresaderm but not for a diabetic, and it's not my favorite ear treatment. There are alternatives but which one may depend on what kind of ear infection he has. Baytril Otic (Enrofloxacin) is an antibacterial/antifungal and requires a prescription. Zymox, which I have used, has a whole line of ear care products including wipes, some with 1.0% hydrocortisone to relieve itching.
https://www.chewy.com/s?query=zymox ear&nav-submit-button=

As to the wobbling, it sounds like vestibular syndrome and can occur with the application of ear medications as well as the infection/inflammation itself - especially in cats - and can affect balance and coordination. A head tilt and eyes rapidly darting back and forth (Nystagmus), vomiting, nausea and loss of appetite due to dizziness are common symptoms.

With what you've described and Gucci's difficulties with balance, stop using the medication and contact your veterinarian, or maybe a different one, as there can be other causes. In the meantime keep him safe, away from stairs, etc.
 
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